【摘要】 目的:分析上海市某区社区卫生服务中心全科医生专科疾病诊疗能力提升意愿及其影响因素，为进一步提升社区卫生服务中心诊疗能级提供参考。方法:2023年7月对上海市某区社区卫生服务中心全科医生展开调查，调查内容包括个人基本情况、培训情况、专科疾病诊疗能力提升意愿等，并且对社区卫生服务中心全科医生、社区管理人员展开10场访谈，了解当前社区全科医生专科疾病诊疗能力培养现状，分析存在的问题及影响全科医生专科疾病诊疗能力提升意愿的因素。结果:上海市某区59.91%的全科医生期望提升专科疾病诊疗能力，具有较高提升需求的科室依次为内科(30.22%)、皮肤科(28.06%)、康复科(25.18%)、精神科(20.14%)、外科(20.14%)等。年龄、学历和职业发展满意度是影响全科医生专科疾病诊疗能力提升意愿的关键因素，年轻、硕士及以上学历的医生具有更强的专科疾病诊疗能力提升意愿；48.2%的全科医生希望采用全专联合门诊和日常业务学习等培训形式；阻碍全科医生专科能力提升意愿最主要的因素是缺乏额外的时间和精力。收入与绩效减少、不确定的职业发展规划以及工作与生活平衡困难影响全科医生专科疾病诊疗能力提升意愿。结论:上海市某区社区卫生服务中心全科医生的专科疾病诊疗能力提升意愿存在差异，缺乏额外的时间和精力为主要的阻碍因素。社区卫生服务中心应立足社区需求开展特色专科诊疗，制定合理的激励措施，建立医生接受度高、线上线下结合的混合专科能力培养模式。更多还原

【Abstract】 Objective: To analyze the willingness of general practitioners of community health centers in a district of Shanghai to improve their specialist competence and the factors influencing them, so as to provide references for further enhancing the diagnosis and treatment capacity of community health centers. Methods: In July 2023, a questionnaire on capacity enhancement of medical personnel in community health centers was used to survey general practitioners in community health centers in a district of Shanghai, which included the following: basic personal information, status of training programs and the willingness to improve the diagnostic and treatment capabilities for specialized diseases. 10 interviews were conducted with general practitioners and community managers in community health centers to understand the current status of cultivating general practitioners’ diagnostic and treatment capabilities for specialized diseases in the community, and to analyze the existing problems and the factors affecting the willingness to improve general practitioners’ diagnostic and treatment capabilities for specialized diseases. Results: In a district of Shanghai, 59.91% of general practitioners expect to improve their diagnostic and treatment capabilities for specialized diseases. The departments with relatively high demand for improvement are in the following order: internal medicine(30.22%), dermatology(28.06%), rehabilitation medicine(25.18%), psychiatry(20.14%), surgery(20.14%) and so on. Age, educational background, and career development satisfaction are the key factors influencing general practitioners’ willingness to enhance their capabilities. Younger doctors with a master’s degree or above show a stronger desire to improve their professional skills. 48.2% of general practitioners prefer training methods such as combined general-specialist outpatient clinics, and daily business learning. The primary factor hindering general practitioners’ willingness to improve their specialized capabilities is lack of extra time and energy. Reduced income and performance, uncertain career development plans, and difficulties in achieving work-life balance also affect general practitioners’ willingness to improve their diagnostic and treatment capabilities for specialized diseases. Conclusion: There are differences in the willingness of general practitioners in community health centers in a district of Shanghai to enhance their diagnostic and treatment capabilities for specialized diseases. The lack of extra time and energy is the main obstacle. Community health centers should carry out characteristic specialized disease diagnosis and treatment based on community demands, formulate reasonable incentive measures, and establish a mixed training model for specialized capabilities that is highly acceptable to doctors and combines online and offline methods.更多还原